The purpose of the project is the creation of specific working programs for measuring and improving health care effectiveness for Colorado people. The Project will move, in a phased growth process, on two converging, interacting lines. One is the development of a process, using peer review supported by an automated data system, which could eventually be capable of providing effective health care monitoring at a state-wide level for all Colorado citizens. The other is the testing and demonstration of this process, as it is being developed, in a series of specific medical care review and facilities utilization review action projects, undertaken with the sponsorship and financial support of third party payers. The greatest significance of the project lies in the promise it gives of being an effective, replicable way of working within the mainstream of the delivery of health care to make marked improvements in quality, access, costs - and eventually, outcome - of health care.